HomeMy WebLinkAboutWater Well Report Card No. 082531 - OT General - 10/29/1991 V
Fite Original and First Copy with WATER WELL REPORT F Start c"°"° 082531
Department of Ecology
Second Copy—Owner's Copy STATE OF WASHINGTON %O
Third Copy—Drillers COPY Water Right PsmWNo_
L (1) OWNER: Name—Grapeview Post Office. Ad,.. E 4290 Gra&Wiew Loop Rd Gra ew
C (2) LOCATION OF WELL: County —Mason - NE % NW % See 8 T.--2-1—N..R iW w.M.
(23) STREET ADODRESS OF WELL(or nearest address) E 4290 Grapeview Loop Rd Grapeview WA 98546 ___
Q) (3) PROPOSED USE: (5 Domestic Industrial ❑ Municipal❑ (10) WELL LOG Or ABANDONMENT PROCEDURE DESCRIPTION
❑ irrigation
❑ Dewater Test Well ❑ Other ❑ Formation: Describe by color. character, aim of material sad etraeturs. end stow
thickness of aquifers and the kind and nature of the material In each stratum psnetnted,
N (4) TYPE OF WORK:Owners nsmb'"of"N with at least one entry for each disrws of infortnation.
S (if more than one) MATERIAL _- - FROM To
.a.+ Abandoned D New well ® Method: Dug ❑ Bored ❑
r_ Deepened ❑ Cable 2 Driven ❑ --
O Reconditioned ❑ Rotary❑ Jetted ❑ to 0 4
C I
O (5) DIMENSIONS: Diameter of well 6 inches.
+' 96 feet. Depth of completed well 96 ft. 4 40
� Drilled
E (6) CONSTRUCTION DETAILS: water 40 47
L --—
t0 Casing Installed: 6 Diam.from ff.10 91 ft. ---
Welded KI Diam.lrom h.to ft. 47 68
Liner installed U
Threaded ❑ Diam.from ft.to ft.
Perforations: Yes No® cewnted sand & gravel with water 68 90
>` Type of perforator used
SIZE of pedoratlons in.by In. 90 96
pertoreHons from It to ft.
pertwations from ft.to _-
Perforations from a.to h.
14 Screens: YesLA No
Manufacturer's NM CcInk --
Type Stainless ___ UO"No
J..r Dlam 51' —Slot size 40 hom__91___ft.to- 96 —fL
+�+ Diem. Slot sin from ft.to ff-
R
Gravel packed: Yes No Siva of gnval
L
� Gravel pitted from d.to R.
ySurface goal: Yes® No❑ Towhatdepih?—_— 18 N.
Material used in seat Betoni to {�I — —
O Did any strata contain unusable water? Yes❑ NoX
Z Type of wale R Depth of strata— �_ -
H Method of sealing strata off
O (7) PUMP: Manufacturer's Name Jacuzzi_
Type: Sur], H.P.
Landion
0 (a) WATER LEVELS: above
alel
O ■locus moan sea level ft.
Static level 23_-� fl.below top of well Date
Artesian pressure lbs.per square inch Date-
0
W Artesian water is controlled by��-_-1-w ate �7C
Work startsd_ -,t9. Co tared 1V �.1s�
O (9) WELL TESTS: Drawdown is amount water level is lowered below static level
�+ We$a pump tell made?Yes[] Noll Ifyes.bywbom? WELL CONSTRUCTOR CERTIFICATION:
Yield: gal./miith ft.drawdown after two.
T n.w I constructed and/or accept responsibility for construction of this well.
and its compliance with all Washington well construction standards.
4-1 __ _ - __ Materials used and the information reported above are true to my beat
L - - -" knowledge and belief.
Recovery data(time taken as zero when pump turned off)(water level measured
IZ from wait top to wolw level) 7� y
(L T .. Water Lwel Ti— Wsier L*vet Tune WNerlevel NAM@ DA Drilling -
Q — (PERSON.FIRM,OR CORPORATION) (TYPE OR PRINT)
Address RPl fair WA 98528
t
oats°,,.at_
(Signed) icense No. 1706 -
eallerteat 1_gsUmin.with 2.5 fl.drowdownafter_L two, fxmL
Contractor 8 u
Airtesl 921./min.with stem se)at It.for hrs.
N .OO 4DT1-1CM Date 0Ct
Artesian Row __g-p-m. Date NO.
- —
Tempereture of water_Was chemical analysis made? YeaD NOEL (USE ADDITIONAL SHEETS IF NECESSARY)
ECYor,o-1.2o (io,87) 1320. ' ►'